3rd International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV 23-26 October 2001, Athens, Greece

Significant correlation between fat distribution abnormalities, elevated plasma lipid levels and asymptomatic hyperlactatemia: a possible connection between lipodystrophy and mitochondrial toxicity

Antiviral Therapy 2001; 6(Suppl. 4):26 (abstract no. 33)

A Antela, S Moreno, J Rubí, E Pallarés, M Pumares, JL Casado, MJ Pérez-Elías, F Dronda, A Moreno, L Moreno, ME Moreno and C Quereda
Ramony Cajal Hospital,Madrid, Spain

BACKGROUND: Hyperlactatemia (HL) can be a consequence of mitochondrial toxicity (MT) due to nucleoside analogue-containing therapy. Some studies give nucleoside analogues a possible role in the development of fat distribution abnormalities (FDA) through MT. Therefore, HL could be an early marker of FDA in asymptomatic patients.

OBJECTIVE: To evaluate the association between HL, FDA, and metabolic alterations found in FDA syndromes.

METHODS: Blood lactate levels were determined in 112 consecutive, unselected, asymptomatic patients receiving nucleoside analogues, following the methods of the ACTG. FDA were evaluated by physician and patient.

RESULTS: Most patients (68%) were male, mean age of 39 years old, 47% former intravenous drug users, 38% with AIDS. Median CD4 cells count and viral load were 446/µl and 1.7 log₁₀ copies/m³. FDA was present in 35.2% (84% lipoatrophy). Median lactate levels were 1.24 mmol/l (0.47-2.8), being >2 mmol/l in 9.8% of patients. In the multivariate analysis, the only significant factor related to HL was older age [P=0.03; RR: 0.87 (0.77-0.99)]. A correlation between HL and FDA was found [P=0.008; OR: 2.55 (1.58-4.11)]. Median lactate leyels in patients with and without FDA were 1.59±0.53 and 1.21±0.42 mmol/l (P<0.001). Also, a correlation was found between HL and cholesterol (p=0.002) and triglycerides (P<0.001) levels. HL was significantly associated with hypercholesterolemia >260 mg/dl [P=0.025; OR: 5.71 (1.4-23.3)] and hypertriglyceridemia >170 mg/dl [P=O.Ol; OR: 6.92 (1.42-33.7)]. Mean cholesterol and triglycerides levels with and without HL, were respectively: 235±60 versus 195±51 mg/dl (P=0.01) and 418±189 versus 296±150 mg/dl (P=0.02).

CONCLUSIONS: A correlation was found between HL and FDA, suggesting a possible role for HL in asymptomatic patients receiving nucleoside analogues as a predictor of FDA. There is a correlation between HL and elevated plasma lipid levels, further suggesting a connection between MT and FDA.

011023
33

Copyright © 2001 - International Medical Press Ltd. Reproduction of this abstract (other than one copy for personal reference) must be cleared through the Medical Editor, International Medical Press, 36 St Mary-at-Hill, London EC3R 8DU, United Kingdom.